Abstract
AbstractBackground: Serum amyloid A is an acute-phase protein. There is no available data regarding serum amyloid A levels in patients with acute (AU) and chronic urticaria (CU).Objectives: To investigate the association between serum amyloid A and urticaria.Methods: This was a case-control study of 81 patients who visited our Hospital between June and December 2016 with a diagnosis of urticaria. Eighty healthy controls (HC) who visited for routine health examination and physical checkups were recruited. Serum amyloid A and C-reactive protein levels were measured by automated methods.Results: Serum amyloid A and C-reactive protein levels were significantly higher in AU (Serum amyloid A: 207.1 (6.7-439.0) mg/L; C-reactive protein: 16.0 (0.2-90.0) mg/L) and CU (Serum amyloid A: 6.5 (2.5-35.8) mg/L; C-reactive protein: 1.0 (0.1-16.0) mg/L) compared with HC (Serum amyloid A: 5.04 (2.0-9.1) mg/L; C-reactive protein: 1.2 (0.1-5.6) mg/L), and in AU compared with CU (all P<0.05). There were no differences between the CU and HC group. In CU, Serum amyloid A levels in those with moderate/severe urticaria (median, 16.4 (9.7-35.8) mg/L) were higher than in those with mild urticaria (median, 5.7 (2.5-9.5) mg/L) and HC (all P<0.05). Serum amyloid A and C-reactive protein levels exceeded the normal lab range in 90.7% and 72.1% patients with AU compared with 28.9% and 13.2% patients with CU, respectively. Significant positive correlations were found between serum amyloid A and C-reactive protein (r = 0.562, P < 0.001).Study limitations: There was no comparison between active disease and remission.Conclusion: There was an association between serum amyloid A levels and urticaria. Higher serum amyloid A levels were associated with AU and more severe CU. Serum amyloid A may help to identify CU patients earlier.
Highlights
Urticaria is a disease defined by the appearance of pruritic wheals and/or angioedemas.[1,2,3] The peak age for onset in adults is between 20 and 40 years.[4]
The healthy controls (HC) group consisted of 80 healthy individuals (46 women and 34 men) of comparable age (38.5, 19-74 years) and body mass index (BMI) (Table 1)
SAA levels in AU and chronic urticaria (CU) patients SAA and C-reactive protein (CRP) levels were significantly higher in AU patients (SAA: 207.1 (6.7-439.0) mg/L; CRP: 16.0 (0.2-90.0) mg/L) than in CU patients (SAA: 6.5 (2.5-35.8) mg/L; CRP: 1.0 (0.1-16.0) mg/L) and HC (SAA: 5.0 (2.0-9.1) mg/L; CRP: 1.2 (0.1-5.6) mg/L) (Figure 1)
Summary
Urticaria is a disease defined by the appearance of pruritic wheals and/or angioedemas.[1,2,3] The peak age for onset in adults is between 20 and 40 years.[4]. Some cases may be idiopathic.[2,3,7] AU is mostly related to mast cell and basophil activation caused by several triggers, which include IgE mediation, acute viral/bacterial infection, food, and allergic or pseudoallergic reaction to drugs.[8] Compared to AU, CU is characterized by events of continuous activity (more than 6 weeks).[2,3,7] It is a more complex disease that has several triggering and aggravating factors,[9] including chronic persistent infections, physical stimuli, drugs, and autoimmune mechanisms. There is no available data regarding serum amyloid A levels in patients with acute (AU) and chronic urticaria (CU). Serum amyloid A and C-reactive protein levels were measured by automated methods. Higher serum amyloid A levels were associated with AU and more severe CU.
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